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CMS RVU26D · Effective 2026-10-01

35180 AV fistula repair Medicare reimbursement rates in Maine

Surgical repair of a congenital artery-to-vein fistula in the head or neck, reported when the surgeon treats the abnormal connection operatively. Compare 35180 office and facility rates across CMS payment localities in Maine.

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

What does Medicare pay for 35180 in Maine?

Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$661.76–$670.00

2 of 2 localities have a supported rate.

Lowest: Rest Of Maine

Highest: Southern Maine

A spread of $8.24 per service.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 35180 in your payment locality →

Vascular surgery

About 35180: Congenital head and neck AV fistula repair

Surgical repair of a congenital artery-to-vein fistula in the head or neck, reported when the surgeon treats the abnormal connection operatively.

35180 describes operative repair of a congenital arteriovenous fistula located in the head or neck. The surgeon treats an abnormal artery-to-vein connection that has been present since birth; the operation may involve interrupting the connection and addressing the involved vessels. Vascular surgeons and other surgeons managing head and neck vascular lesions may perform the procedure in a hospital operating room.

Report this code when the documented lesion is congenital, is in the head or neck, and is surgically repaired. The operative report should support the lesion’s origin, location, and repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 35180

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU14.72 · 69%
  • Practice expense (office) RVU3.00 · 14%
  • Malpractice RVU3.75 · 17%

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

35180 compared with similar codes

Office rates for Maine, from the same CMS release.

35188

AV fistula repair

Acquired, head and neck

No office rate

Both address a head or neck fistula, but 35180 is for congenital origin and 35188 is for acquired origin.

35182

AV fistula repair

Congenital, thorax or abdomen

No office rate

Both are for congenital fistula repair; 35182 applies to the thorax or abdomen rather than the head or neck.

35184

Fistula repair

Congenital, extremity

No office rate

Both are for congenital fistula repair; 35184 applies to an extremity rather than the head or neck.

Compare 35180 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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35180 billing questions

How do I distinguish 35180 from 35188?

Use 35180 for a congenital fistula in the head or neck. Code 35188 describes repair of an acquired fistula at that location.

Which code applies when the congenital fistula is outside the head and neck?

Choose the congenital fistula code for the documented site: 35182 for the thorax or abdomen, or 35184 for an extremity.

Is modifier 50 appropriate for bilateral repair?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 35180PPRRVU2026_Oct_nonQPP.csv, line 4,286 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet